MEDICARE: KRISTA M. CLARK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	4018836	OTHER	TN	BCBS OF TN

General Provider Information

NPI Number	:	1710161831
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KRISTA M. CLARK

Provider Business Mailing Address
First Line	:	810 HADLEY AVE
Second Line	:
City	:	OLD HICKORY
State	:	TN
Zip	:	37138-3121
Country	:	US
Telephone Number	:	615-847-8000
Fax Number	:	615-847-4693

Provider Business Practice Location Address
First Line	:	810 HADLEY AVE
Second Line	:
City	:	OLD HICKORY
State	:	TN
Zip	:	37138-3121
Country	:	US
Telephone Number	:	615-847-8000
Fax Number	:	615-847-4693

Authorized Official
Title or Position	:	OWNER
Name	:	KRISTA M CLARK
Credential	:	CFM
Telephone Number	:	615-847-8000

Provider Enumeration Date	:	12/26/2007
Last Update Date	:	01/16/2013

Similar Medicare Providers

1679575591 — DIANE MARIA CAMPBELL DNP,FNP- BC
Practice Location Address:

808 HADLEY AVE
OLD HICKORY, TN
37138-3121

Practice Phone: 615-425-4900
Practice Fax: 615-425-4922

1073687224 — KRISTA M CLARK
Practice Location Address:

810 HADLEY AVE
OLD HICKORY, TN
37138-3121

Practice Phone: 615-847-8000
Practice Fax: 615-847-4693

1265580328 — DR. KEVIN JAMES WORLEY DDS
Practice Location Address:

808 HADLEY AVE
OLD HICKORY, TN
37138-3121

Practice Phone: 615-847-3821
Practice Fax: 615-847-5544

1336847615 — TELEMATE, LLC
Practice Location Address:

810 HADLEY AVE
OLD HICKORY, TN
37138-3121

Practice Phone: 615-806-4987
Practice Fax:

1407624364 — TELEMATE HEALTH INC
Practice Location Address:

810 HADLEY AVE
OLD HICKORY, TN
37138-3121

Practice Phone: 615-476-5656
Practice Fax: 615-810-8516

1487514410 — RACHAEL JEANNINE SONG RN
Practice Location Address:

221 WILD OAK LN
HICKORY CREEK, TX
75065-3121

Practice Phone: 940-354-3176
Practice Fax:

Directions to “KRISTA M. CLARK ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.